Evidence map›Paper›PMID 30251154›Full record

Trial reportEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2020

Weight-bearing or non-weight-bearing after surgical treatment of ankle fractures: a multicenter randomized controlled trial.

Diederik Pieter Johan Smeeing, Roderick Marijn Houwert, Jan Paul Briet, Rolf Hendrik Herman Groenwold, Koen Willem Wouter Lansink, Luke Petrus Hendrikus Leenen, Peer van der Zwaal, Jochem Maarten Hoogendoorn, Mark van Heijl, Egbert Jan Verleisdonk and 2 more

2 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 53 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05256628 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Early Versus Delayed Weightbearing in FemoroAcetabular Impingement Syndrome Patients Undergoing Treatment With Arthroscopic HIP Osteochondroplasty: a Randomized Controlled Non-inferiority Trial

TypeinterventionalSponsorWomen's College HospitalRan2022 to 2024Enrolled240ConditionsFemoroacetabular Impingement SyndromeArmsEarly Weightbearing, Protected Weightbearing
NCT07521696 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Physical Recovery During Bracing After Ankle Fracture (Re-BAF): A Multi-Center Superiority Analysis Nested Within a Non-inferiority Randomised Controlled Trial (BAF; NCT07163091)

TypeinterventionalSponsorOdense University HospitalRan2026 to 2029Enrolled280ConditionsAnkle Fracture, Recovery, Physical Activity, RehabilitationArmsAnkle stirrup, Foot-ankle brace
3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
  2. Rehabilitation following locked intramedullary fibular nail fixation: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Rehabilitation for ankle fractures in adults.The Cochrane database of systematic reviews · 2024
    Pooled it
  8. Pooled it
  9. Pooled it
  10. How to assess applicability and methodological quality of comparative studies of operative interventions in orthopedic trauma surgery.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Pooled it
  11. Pooled it
  12. Trial
  13. Trial
  14. Trial
  15. Review
  16. The Diagnosis, Treatment, and Aftercare of Ankle Fractures.Deutsches Arzteblatt international · 2026
    Review
  17. Article
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Diederik Pieter Johan SmeeingDepartment of Surgery, St. Antonius Hospital Nieuwegein, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands. d.p.j.smeeing@umcutrecht.nl.
Roderick Marijn HouwertUtrecht Traumacenter, Utrecht, The Netherlands.
Jan Paul BrietDepartment of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Rolf Hendrik Herman GroenwoldDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Koen Willem Wouter LansinkDepartment of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
Luke Petrus Hendrikus LeenenDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Peer van der ZwaalDepartment of Orthopaedics, Haaglanden Medisch Centrum, The Hague, The Netherlands.
Jochem Maarten HoogendoornDepartment of Surgery, Haaglanden Medisch Centrum, The Hague, The Netherlands.
Mark van HeijlDepartment of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Egbert Jan VerleisdonkDepartment of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
Michiel Joseph Marie SegersDepartment of Surgery, St. Antonius Hospital Nieuwegein, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands.
Falco HietbrinkDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe goal of this study was to assess if unprotected weight-bearing as tolerated is superior to protected weight-bearing and unprotected non-weight-bearing in terms of functional outcome and complications after surgical fixation of Lauge-Hansen supination external rotation stage 2-4 ankle fractures.

methodsA multicentered randomized controlled trial was conducted in patients ranging from 18 to 65 years of age without severe comorbidities. Patients were randomized to unprotected non-weight-bearing, protected weight-bearing, and unprotected weight-bearing as tolerated. The primary endpoint of the study was the Olerud Molander Ankle Score (OMAS) 12 weeks after randomization. The secondary endpoints were health-related quality of life using the SF-36v2, time to return to work, time to return to sports, and the number of complications.

resultsThe trial was terminated early as advised by the Data and Safety Monitoring Board after interim analysis. A total of 115 patients were randomized. The O'Brien-Fleming threshold for statistical significance for this interim analysis was 0.008 at 12 weeks. The OMAS was higher in the unprotected weight-bearing group after 6 weeks c(61.2 ± 19.0) compared to the protected weight-bearing (51.8 ± 20.4) and unprotected non-weight-bearing groups (45.8 ± 22.4) (p = 0.011). All other follow-up time points did not show significant differences between the groups. Unprotected weight-bearing showed a significant earlier return to work (p = 0.028) and earlier return to sports (p = 0.005). There were no differences in the quality of life scores or number of complications.

conclusionsUnprotected weight-bearing and mobilization as tolerated as postoperative care regimen improved short-term functional outcomes and led to earlier return to work and sports, yet did not result in an increase of complications.

Indexed as

Casts, SurgicalCrutchesEarly AmbulationQuality of LifeWeight-BearingAdolescentAdultAgedAnkle FracturesFemaleFracture Fixation, InternalHumansMaleMiddle AgedPostoperative CarePostoperative ComplicationsAnkle fractureMobilizationPostoperative careRandomized controlled trialWeight-bearing

Identifiers

PMID30251154
PMCPMC7026225

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.